Slovo úvodem

MUDr. Michal Prokeš, PharmDr. Josef Suchopár

Klin Farmakol Farm. 2025;39(1):4  

Clinically relevant drug-drug interactions with nirmatrelvir/ritonavir in patients on chronic pharmacotherapy

Zuzana Mačeková, Veronika Tomášová, Katarína Pajerová, Mária Kolesárová, Ondřej Šimandl, Eva Kmoníčková, Ján Klimas, Ivan Vaňo, Mária Göböová

Klin Farmakol Farm. 2025;39(1):5-13 | DOI: 10.36290/far.2025.018  

Introduction: Nirmatrelvir/ritonavir is indicated for the treatment of COVID-19 dise­ase in high-risk patients. Its administration is limited by the significant effect of ritonavir on the CYP enzyme system and its isoforms. Ritonavir potentiates the effect of concomitantly administered nirmatrelvir and it also causes pharmacotherapeutic complications in patients on chronic drug therapy. Aim: To identify drug-drug interactions of nirmatrelvir/ritonavir with drugs from different ATC groups used in chronic pharmacotherapy, to assess the risk of potential drug-drug interactions and to summarize clinically relevant interactions and thereby contribute to...

Lipid lowering with inclisiran: a single-center experience from Slovakia

Stefan Toth, Marianna Barbierik Vachalcova, Adriana Jarolimkova, Martin Sevcik, Tibor Poruban

Klin Farmakol Farm. 2025;39(1):14-21 | DOI: 10.36290/far.2025.017  

Background: Inhibiting proprotein convertase subtilisin/kexin type 9 activity is an effective strategy to lower LDL cholesterol (LDL-C), a major cardiovascular risk factor. Inclisiran, the first small interfering RNA targeting PCSK9, has shown a 50% LDL-C reduction in clinical trials. Aims: The aim of this study was to describe the effects of inclisiran in real-world clinical settings, along with the first clinical experiences of its use in Slovakia. Methods: In this observational study, 36 patients were selected for inclisiran therapy as part of standard clinical assessments, procedures, and reimbursement from public health insurance. Each patient...

Pharmacokinetic drug-drug interactions of direct oral anticoagulants

Josef Suchopár, Michal Prokeš, Štěpán Suchopár

Klin Farmakol Farm. 2025;39(1):22-33 | DOI: 10.36290/far.2025.014  

Direct-acting oral anticoagulants (DOACs) - dabigatran etexilate, rivaroxaban, apixa­ban and edoxaban - have a number of clinically significant pharmacokinetic drug interactions, with significant differences in the severity of these interactions between individual drugs. Metabolic and transport processes play a key role, especially metabolism via CYP3A4 and CYP2J2 and the transport via P-glycoprotein and possibly BCRP. Inhibitors and inducers of these enzymes and transport systems can change DOAC exposure and thus the risk of bleeding, or the risk of reduced efficacy or failure of therapy. Knowledge of these drug interactions is crucial for optimizing...

Drug-drug interactions of DOAC and anticonvulsants

Michal Prokeš, Josef Suchopár

Klin Farmakol Farm. 2025;39(1):34-43 | DOI: 10.36290/far.2025.015  

In developed countries, more and more patients are being treated with DOACs, the use of which, unlike until recently preferred warfarin, cannot be easily titrated in common medical practice. It is therefore important, when dosing DOACs, to follow the recommendations issued by the marketing autorisation holders in SmPC and guidelines issued by professional societies of physicians, taking into account the condition of individual patients. Drug interactions of DOACs with specific anticonvulsants may cause a reduction in anticoagulant effect in some patients, and new studies suggest that there may also be an increased risk of bleeding events, for example...

Drug-drug interactions of drugs for treatment of overactive bladder

Michal Prokeš, Josef Suchopár

Klin Farmakol Farm. 2025;39(1):44-51 | DOI: 10.36290/far.2025.016  

The consumption of drugs used for the treatment of overactive bladder (OAB) in the Czech Republic has increased significantly over the past 10 years, and the number of potential drug interactions of these drugs is undoubtedly also increasing. This review article summarizes the current knowledge on this issue in order to provide treating physicians with the information necessary for optimal pharmacotherapy of OAB, which includes individual selection of drugs with regard to the patient's condition and drugs that are being used for other diseases.

Sex-related differences - from pharmacology to clinical research methodology

Adriána Papiež, Zora Čechová, Jitka Rychlíčková

Klin Farmakol Farm. 2025;39(1):52-56 | DOI: 10.36290/far.2025.019  

Expert community and even patients are increasingly concerned about whether the results of clinical trials can be applied to patient subgroups that were not originally included in the research. Regarding this, female population is the most frequently discussed. Biological sex significantly influences the pharmacokinetics and pharmacodynamics of drugs, leading to differences in both therapeutic and adverse effects. Despite this, women have been historically under-represented in clinical studies, for example in cardiovascular research. Although female participation has improved in recent years, disparities persist. This article explores the historical...

The use of therapeutic second-generation antipsychotics level monitoring in the individualization of schizophrenia pharmacotherapy

Anna Králová, Petr Potměšil, Miloslav Kopeček

Klin Farmakol Farm. 2025;39(1):57-61 | DOI: 10.36290/far.2025.020  

Therapy for schizophrenia involves a complex treatment plan consisting of social interventions, psychotherapy, and pharmacotherapy. Second-generation antipsychotics are the cornerstone of the treatment due to their pharmacological profile and lower incidence of side effects. Antipsychotika treatment is long-term and extends beyond the acute phase. Maintenance therapy is crucial to prevent relapse. Determining the plasmatic levels of antipsychotic drugs, known as therapeutic drug monitoring, helps adjust the dose for each patient individually. This process also helps minimize toxicity, monitor adherence, and reduce treatment costs.

Psychedelics in the treatment of cluster headaches

Michal Židó, Tomáš Páleníček, Ivana Štětkářová

Klin Farmakol Farm. 2025;39(1):62-66 | DOI: 10.36290/far.2025.021  

Psychedelics are psychoactive substances that typically cause changes in perception, thinking, emotionality, and cognitive processes immediately after use. Recently, their antidepressant and anxiolytic effects have been intensively investigated. The main advantage of these substances is the rapid onset and long-lasting effect after administration of one or only a few doses. They also have a good safety profile. These substances can also be used to treat chronic neurogenic pain and primary headaches, e.g. cluster headache. Cluster headache is a rare disease, manifested by episodes of intense headaches with vegetative accompaniment, which can significantly...